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Clear Spring Health is a private insurance company offering Medicare Advantage plans, also known as Medicare Part C. These plans provide an alternative to Original Medicare by bundling hospital (Part A), medical (Part B), and often prescription drug (Part D) coverage, along with additional benefits like dental, vision, and hearing services.
Frequently Asked Questions (FAQs)
1. What is Medicare Advantage (Part C)?
Medicare Advantage plans are offered by private insurance companies and include all services covered under Original Medicare Parts A and B. Many plans also incorporate Part D prescription drug coverage and may offer extra benefits such as dental, vision, hearing, transportation, gym memberships, and allowances for over-the-counter health items. These plans often feature low or $0 monthly premiums.
2. What types of Medicare Advantage plans does Clear Springs Health offer?
Clear Spring Health offers various Medicare Advantage plans, including.
Health Maintenance Organization (HMO):
Requires members to use in-network providers for coverage, except in emergencies. Referrals from primary care physicians are typically needed to see specialists.
Preferred Provider Organization (PPO):
Allows members to see out of network providers at a higher cost and generally does not require referrals for specialists
Special Needs Plans (SNP):
Tailored for individuals with specific conditions or circumstances, such as those eligible for both Medicare and Medicaid (Dual SNP) or those with chronic conditions (Chronic SNP).
Not all plan types are available in all areas, so it’s essential to check the specific offerings in your region.
3. How do I enroll in a Clear Spring Health Medicare Advantage plan?
To enroll in a Medicare Advantage plan with Clear Spring Health, you must:
Be enrolled in both Medicare Part A and Part B.
Reside in the plan’s service area.
Be a U.S. citizen or lawfully present in the U.S.
Enrollment periods include:
Initial Enrollment Period (IEP):
A seven-month window starting three months before your 65th birthday month, including the birthday month, and ending three months after.
Annual Enrollment Period (AEP):
Occurs from October 15 to December 7 each year, allowing you to enroll in or switch Medicare Advantage plans.
Medicare Advantage Open Enrollment Period (OEP):
From January 1 to March 31 each year, this period allows those already enrolled in a Medicare Advantage plan to switch plans or return to Original Medicare.
Special Enrollment Periods (SEPs):
Certain life events, such as moving or losing other insurance coverage, may qualify you for a SEP to enroll or make changes to your plan outside the standard enrollment periods.
For assistance with enrollment, you can contact Clear Spring Health directly or consult with a licensed insurance agent.
4. What additional benefits do Clear Spring Health Medicare Advantage plans offer?
Beyond the standard hospital and medical coverage, many Clear Spring Health Medicare Advantage plans provide additional benefits, which may include:
Dental Coverage:
Routine exams, cleanings, and other dental services.
Vision Coverage:
Eye exams, glasses, and contact lenses.
Hearing Coverage:
Hearing exams and hearing aids.
Over the Counter (OTC) Benefits: Allowances for purchasing OTC health items.
Fitness Programs:
Gym memberships or fitness class discounts.
Transportation Services:
Rides to and from medical appointments.
Utility Allowances:
Assistance with utility bills.
Specific benefits vary by plan and location, so reviewing the details of each plan is crucial to understand the exact offerings.
5. How does Clear Spring Health ensure the quality of its Medicare Advantage plans?
Clear Spring Health is committed to providing high-quality healthcare coverage. The company continually evaluates and updates its plans to meet the evolving needs of its members. Clear Spring Health also complies with regulations set forth by the Centers for Medicare & Medicaid Services (CMS) to maintain the integrity and quality of its offerings.
6. Has Clear Spring Health been involved in any recent acquisitions?
Yes, in May 2019, Clear Spring Health completed the acquisition of Community Care Alliance of Illinois, NFP (CCAI). This acquisition received regulatory approval from Illinois regulators, the supervising Circuit Court, and federal regulators. The integration ensured continued coverage and service to all CCAI policyholders without any changes to their medical or prescription coverage, including provider and pharmacy access.
7. How does Clear Spring Health handle data security and privacy?
Clear Spring Health prioritizes the security and privacy of its members’ information. In June 2024, the company issued a notice informing members about a security breach at Change Healthcare, one of its vendors. The breach, caused by a ransomware attack, resulted in the theft of sensitive data, including personal and health information. Clear Spring Health promptly notified affected members and provided guidance on protective measures. This incident underscores the importance of robust cybersecurity measures within the healthcare sector.
8. What do employees say about working at Clear Spring Health?
Employee reviews of Clear Spring Health vary. Some employees have expressed concerns about management, corporate strategy, and work culture. For instance, reviews on Indeed.com highlight issues such as unclear direction from management and limited advancement opportunities.
